Instructions for SF-1199A


Producers use this form to sign up for the direct deposit of benefits from USDA into the account of a payee.

Producers must complete items A through F and provide a signature in Section 1 and all entries in Sections 2 and 3.

Section 1

Fld Name /
Item No.



Name of Payee

Enter last name, first name and middle initial of payee.

Enter complete mailing address of payee.

Enter area code and telephone number of payee.


Name of Persons Entitles to Payment

Enter complete name of payee.


Claim or Payroll ID Number

Enter the social security number or employer identification number of payee.


Type of Depositor Account

Mark appropriate type of deposit account.


Depositor Account Number

Enter the account number of the account where payments are to be deposited.


Type of Payment

For USDA purposes, mark box labeled "OTHER" and write "USDA Payments" on the line provided.


Allocation of Payment

Leave blank. No entry is required in this item.



Sign and date under "Payee/Joint Payee Certification" No entry is needed under the Joint Account Holders Certification.


Section 2

Fld Name /
Item No.


Government Agency Name

Enter the name of the USDA agency issuing payments that are to be deposited directly into the defined account.

Government Agency Address

Enter the complete mailing address of USDA agency.


Section 3

This section can be completed by option A OR option B:

Fld Name /
Item No.


Option A

Take this form to your financial institution and they will complete and sign section 3 for you. You may have them mail this form to the USDA agency in section 2 or you may deliver it in person or mail it yourself to the USDA office, OR

Option B

Submit this completed form either by mail or in person with a "VOIDED" check attached. USDA personnel will complete section three with information from the voided check.